Author(s):
Bandeira, Matilde ; Dourado, Eduardo ; Melo, Ana Teresa ; Martins, Patrícia ; Fraga, Vanessa ; Ferraro, José Luís ; Saraiva, André ; Sousa, Marlene ; Parente, Hugo ; Soares, Catarina ; Correia, Ana Margarida ; Almeida, Diogo Esperança ; Dinis, Sara Paiva ; Pinto, Ana Sofia ; Oliveira Pinheiro, Filipe ; Rato, Maria Seabra ; Beirão, Tiago ; Samões, Beatriz ; Santos, Bernardo ; Mazeda, Carolina ; Chícharo, Ana Teodósio ; Faria, Margarida ; Neto, Agna ; Lourenço, Maria Helena ; Brites, Luísa ; Rodrigues, Marília ; Silva-Dinis, Joana ; Dias, João Madruga ; Araújo, Filipe C. ; Martins, Nádia ; Couto, Maura ; Valido, Ana ; Santos, Maria ; Barreira, Sofia ; Fonseca, João Eurico ; Campanilho-Marques, Raquel
Date: 2023
Persistent ID: http://hdl.handle.net/10451/58066
Origin: Repositório da Universidade de Lisboa
Subject(s): Biomarkers; Cardiac involvement; Idiopathic inflammatory myopathies; Myocarditis; Predictors; Risk factors
Description
Objectives: Idiopathic inflammatory myopathies (IIM) are a group of rare disorders that can affect the heart. This work aimed to find predictors of cardiac involvement in IIM. Methods: Multicenter, open cohort study, including patients registered in the IIM module of the Rheumatic Diseases Portuguese Register (Reuma.pt/Myositis) until January 2022. Patients without cardiac involvement information were excluded. Myo(peri)carditis, dilated cardiomyopathy, conduction abnormalities, and/or premature coronary artery disease were considered. Results: 230 patients were included, 163 (70.9%) of whom were females. Thirteen patients (5.7%) had cardiac involvement. Compared with IIM patients without cardiac involvement, these patients had a lower bilateral manual muscle testing score (MMT) at the peak of muscle weakness [108.0 ± 55.0 vs 147.5 ± 22.0, p=0.008] and more frequently had oesophageal [6/12 (50.0%) vs 33/207 (15.9%), p=0.009] and lung [10/13 (76.9%) vs 68/216 (31.5%), p=0.001] involvements. Anti-SRP antibodies were more commonly identified in patients with cardiac involvement [3/11 (27.3%) vs 9/174 (5.2%), p=0.026]. In the multivariate analysis, positivity for anti-SRP antibodies (OR 104.3, 95% CI: 2.5-4277.8, p=0.014) was a predictor of cardiac involvement, regardless of sex, ethnicity, age at diagnosis, and lung involvement. Sensitivity analysis confirmed these results. Conclusion: Anti-SRP antibodies were predictors of cardiac involvement in our cohort of IIM patients, irrespective of demographical characteristics and lung involvement. We suggest considering frequent screening for heart involvement in anti-SRP-positive IIM patients.
